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Validation of exercise testing and laryngeal auscultation for grading brachycephalic obstructive airway syndrome in pugs, French bulldogs, and English bulldogs by using whole‐body barometric plethysmography
Author(s) -
Riggs Julia,
Liu NaiChieh,
Sutton Dawn R.,
Sargan David,
Ladlow Jane F.
Publication year - 2019
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/vsu.13159
Subject(s) - medicine , stridor , auscultation , physical examination , larynx , plethysmograph , laryngoscopy , airway , clinical significance , physical therapy , surgery , anesthesia , cardiology , intubation
Objective To determine whether the sensitivity of clinical examination for assessing upper airway disease severity in 3 breeds of brachycephalic dogs can be improved by incorporating an exercise test (ET) or by auscultation of a laryngeal stridor to predict laryngeal collapse. Study design Prospective clinical study. Animals Client‐owned brachycephalic dogs (n = 44 ET; n = 57 laryngeal stridor assessment). Methods In the first part of the study, clinical examinations were performed at rest and after 5‐minute walk and 3‐minute trot tests, and a grade reflective of brachycephalic obstructive airway syndrome (BOAS) severity was assigned. Whole‐body barometric plethysmography was used as a comparative, objective measure of disease severity. In the second part of the study, the degree of laryngeal collapse present in dogs undergoing BOAS surgery was compared to pre‐exercise and postexercise laryngeal stridor detected during functional testing. Results The sensitivity of clinical examination for BOAS diagnosis was 56.7% pre‐ET, 70% after a 5‐minute walk test, and 93.3% after a 3‐minute trot test. The sensitivity of laryngeal stridor as a predictor of laryngeal collapse was improved after exercise (70%) compared with before exercise (60%). Specificity of laryngeal stridor for laryngeal collapse was 100% (pre‐exercise and postexercise). Conclusion The sensitivity of clinical examination for BOAS diagnosis was improved by inclusion of an ET, particularly the 3‐minute trot test. Audible laryngeal stridor was highly specific but only moderately sensitive for laryngeal collapse. Clinical significance Inclusion of a 3‐minute trot test and careful auscultation for laryngeal stridor are recommended during BOAS assessment of brachycephalic dogs.